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General NPI Number Information
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NPI Number | 1275606170
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Entity Type | Organization
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Legal Business Name | SLEEP DISORDERS CENTER OF PR
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 107 GONZALEZ GUISTI AVE CAPARRA GALLERY BUILDING, SUITE 304
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-707-0020
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Fax | 787-782-2056
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Provider Business Mailing Address
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Address Line | 107 GONZALEZ GUISTI AVE. CAPARRA GALLERY BUILDING ,SUITE 304
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-707-0020
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Fax | 787-782-2056
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. YAMIRA HERNANDEZ
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Credential |
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Telephone | 787-707-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 10812
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License Number State | PR
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